Study of prescription-indication of tetracyclines in a population in Colombia.

The inappropriate use of antibiotics is associated with increased antimicrobial resistance, adverse reactions, medical care costs, and worse clinical outcomes. The objective of this study is to determine the prescription patterns and approved and unapproved indications for tetracyclines in a group of patients in Colombia. This was a cross-sectional study, based on a database of medication dispensing of approximately 8.5 million people affiliated with the Colombian Health System, of the indications for the use of tetracyclines in outpatients. Sociodemographic, pharmacological, and comorbidity variables were considered. A total of 20 699 patients with a prescription of tetracyclines were identified, with a median age of 26.1 years; 65.0% were women. The most prescribed tetracycline was doxycycline (95.1%), especially for the treatment of acne (55.3%). A total of 23.5% of the prescriptions was used for unapproved indications, for example, vaginitis-vulvitis-vulvovaginitis (8.1%). Increasing age, prescriptions of doxycycline made by general physician, and woman attended by general physician were associated with a greater probability that a tetracycline was used for unapproved indications. Residing in Bogota-Cundinamarca Region and woman that residing in Bogota-Cundinamarca reduced this risk. A high proportion of patients received tetracyclines for dermatological conditions, with a lower proportion of use for gynecological and respiratory infections. For approximately one quarter of the cases, tetracyclines were prescribed for indications not approved by regulatory agencies, especially in those over 18 years and when the prescriptions of doxycycline was made by a general practitioners.

Molecular and serological prevalence of Coronavirus in Chiropterans: A systematic review with meta-analysis.

In recent years, and now especially with the arrival of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), there has been increased interest in understanding the role of bats in the dynamics of transmission and origin of this pandemic agent. To date, no systematic reviews have been published on this topic. This systematic review aimed to summarize and highlight the frequency of bat infections reported in currently available observational studies for coronavirus. The purpose of this study was also to examine the differences between the pool prevalence by technique and country. We performed a systematic literature review with meta-analysis, using three databases to assess coronavirus (CoV) infection in bats and its diagnosis by serological and molecular tests. We carried out random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95% CI). In all, 824 articles were retrieved (1960-2021). After screening by abstract/title, 43 articles were selected for full-text assessment. Of these, 33 were finally included for qualitative and quantitative analyses. From the total of studies, the pool prevalence by RT-PCR (n=14,295 bats) for CoV was 9.8% (95% CI 8.7-10.9%); Italy reported the highest pooled prevalence (44.9%, 95% CI 31.6-58.1%), followed by the Philippines (29.6%). Regarding the ELISA, the pool prevalence for coronavirus from 15 studies, including 359 bats, was 30.2% (95% CI 14.7-45.6%). The results for coronaviruses with the MIF were significantly lower, 2.6% (95% CI 1.5-3.7%). A considerable proportion of infected bats tested positive, particularly by molecular tests. This essential condition highlights the relevance of bats and the need for future studies to detail their role as potential reservoirs of SARS-CoV-2. In this meta-analysis, bats were positive in almost 10% by RT-PCR, suggesting their relevance and the need to understand their potential participation in maintaining wild zoonotic transmission.